Design features and health outcomes of mHealth applications for patient self-management of asthma: a systematic review

Despite the potential of mobile health (mHealth) apps to provide patients with an effective means to self-manage asthma, to date, little is known about the key design features and health outcomes brought by such apps. Therefore, this study aims to systematically review and examine the research evidence on health outcomes of mHealth apps that support patient self-management of asthma and the key design features to achieve these outcomes. Four databases were searched using the keywords against the eligibility criteria, yielding 446 studies with ten finally included. The thematic analysis identified five key features of the mHealth app - communication, assessment, planning, education and reminder - abbreviated as a CAPER model. Of the nine studies that measured asthma control, eight showed significant positive changes and one remained unchanged. Seven studies measured asthma-related quality of life, seeing three positive changes, three without change, and one only with positive changes in physical measurements but not in mental measurements. Three studies measured asthma medication use with two positive changes and one unchanged. Lung function was measured in two studies while exacerbation, asthma symptoms, asthma education and self-efficacy were measured in only one study and significant positive outcomes only be seen in asthma symptoms and education; the other three remained unchanged. It appears that most mHealth apps for self-management of asthma can improve asthma control, asthma-related quality of life and medication use. Further research is needed to gather sound evidence about the relationship between the key design features and patient outcomes.